March 19, 2007
Doctor's hours | A chat with Robert Fried, founder of Medical House Calls of Southern Maine in Portland.
Founded: September 2006
Employees: One
Startup costs: $10,000
Projected revenue, year one: $80,000
Projected revenue, year two: $140,000
Contact: 318-5348
211 Marginal Way, Ste. 717, Portland 04101
www.mhcsm.com
Tell me about your company.
It's a medical practice with two new concepts. The first one is palliative medicine. That's the skill set developed in the hospice world, [but] brought further upstream in the trajectory of the illness. In other words, why should you have to wait until you're dying to get your pain and other symptoms cared for?
The second is that in many parts of the country, there has been a return of the physician house call. There are people stuck at home ˆ the doctor can't get to them. So I had gotten special training in palliative medicine, and I said, "I think at the convergence of those trends, there could be in the greater Portland area a physician house call practice." And that's what I'm doing.
What had you been doing before?
My original background is in family medicine. There got to be a point when I saw an opportunity to do a fellowship in advanced medical training. So I was accepted into a fellowship in hospice and palliative medicine in San Diego, Calif., and I spent the 2005-2006 academic year there. When the fellowship was over, I had personal reasons to return to Maine, and saw this opportunity.
I've heard doctors are leaving private practice because it's expensive. Is the cost a challenge for you?
It's a tremendous challenge. But the way this can work is if I am careful to bill appropriately and be extremely vigilant about costs. I have no office, the address on my card is a mail box at the UPS Store. The office telephone [is a cell phone], which I answer myself. I don't have any staff. It's not a road to riches, but if I can make the mortgage payment, I'm gonna be okay.
How has it been going?
I have not been as busy as I would like to be yet. This is a new concept and I need to get the word out. Right now, there are a few people I'm looking after for the long run and a slightly larger group that I've seen once or twice as needed.
How do you market the business?
I've been meeting with hospices and home health agencies. I've also done a little bit of advertising, where the response has been underwhelming. So I keep scratching my head about this. I had proposed to a large medical practice that they could have a palliative care department outsourced to me, and I'm hoping that will interest them.
How do you work with the primary care physician?
One way is that Dr. Primary could call me and say, "Could you please see this lady at home and be my eyes and ears?" I would report back both over the phone and in writing. Sometimes Dr. Primary would say, "Can I turn this person over to you?" That's a little bit harder for me to do but not impossible. Also, patients and families sometimes call me directly.
What kinds of illnesses do you treat?
I have been seeing a gentleman who is in his 70s with a form of dementia who has not been out of his house for two years. I have been seeing him every month.
I had a patient of mine die yesterday ˆ an elderly woman in her 80s with high blood pressure and Alzheimer's disease. She was in an assisted living facility, and about 10 days ago had a stroke, so we shifted to end-of-life care. Yesterday morning she developed pneumonia as evidenced by high fever, rapid respiratory rate. Consistent with the wishes of her family, we did not transport her to the emergency department. Instead we managed her shortness of breath in the facility and she died peacefully surrounded by her family.
How do you keep going after a patient dies?
Well, we do have to recognize, as they taught me in medical school, that life is a sexually transmitted disease with a 100% mortality rate. We have to recognize that dying is part of living and that everyone comes to that point. I find great personal satisfaction in accompanying patients through this part of their journey and in being there for them and for their families.
New Entrepreneurs profiles young businesses, 6-18 months old. Send your suggestions and contact information to kelson@mainebiz.biz.
Employees: One
Startup costs: $10,000
Projected revenue, year one: $80,000
Projected revenue, year two: $140,000
Contact: 318-5348
211 Marginal Way, Ste. 717, Portland 04101
www.mhcsm.com
Tell me about your company.
It's a medical practice with two new concepts. The first one is palliative medicine. That's the skill set developed in the hospice world, [but] brought further upstream in the trajectory of the illness. In other words, why should you have to wait until you're dying to get your pain and other symptoms cared for?
The second is that in many parts of the country, there has been a return of the physician house call. There are people stuck at home ˆ the doctor can't get to them. So I had gotten special training in palliative medicine, and I said, "I think at the convergence of those trends, there could be in the greater Portland area a physician house call practice." And that's what I'm doing.
What had you been doing before?
My original background is in family medicine. There got to be a point when I saw an opportunity to do a fellowship in advanced medical training. So I was accepted into a fellowship in hospice and palliative medicine in San Diego, Calif., and I spent the 2005-2006 academic year there. When the fellowship was over, I had personal reasons to return to Maine, and saw this opportunity.
I've heard doctors are leaving private practice because it's expensive. Is the cost a challenge for you?
It's a tremendous challenge. But the way this can work is if I am careful to bill appropriately and be extremely vigilant about costs. I have no office, the address on my card is a mail box at the UPS Store. The office telephone [is a cell phone], which I answer myself. I don't have any staff. It's not a road to riches, but if I can make the mortgage payment, I'm gonna be okay.
How has it been going?
I have not been as busy as I would like to be yet. This is a new concept and I need to get the word out. Right now, there are a few people I'm looking after for the long run and a slightly larger group that I've seen once or twice as needed.
How do you market the business?
I've been meeting with hospices and home health agencies. I've also done a little bit of advertising, where the response has been underwhelming. So I keep scratching my head about this. I had proposed to a large medical practice that they could have a palliative care department outsourced to me, and I'm hoping that will interest them.
How do you work with the primary care physician?
One way is that Dr. Primary could call me and say, "Could you please see this lady at home and be my eyes and ears?" I would report back both over the phone and in writing. Sometimes Dr. Primary would say, "Can I turn this person over to you?" That's a little bit harder for me to do but not impossible. Also, patients and families sometimes call me directly.
What kinds of illnesses do you treat?
I have been seeing a gentleman who is in his 70s with a form of dementia who has not been out of his house for two years. I have been seeing him every month.
I had a patient of mine die yesterday ˆ an elderly woman in her 80s with high blood pressure and Alzheimer's disease. She was in an assisted living facility, and about 10 days ago had a stroke, so we shifted to end-of-life care. Yesterday morning she developed pneumonia as evidenced by high fever, rapid respiratory rate. Consistent with the wishes of her family, we did not transport her to the emergency department. Instead we managed her shortness of breath in the facility and she died peacefully surrounded by her family.
How do you keep going after a patient dies?
Well, we do have to recognize, as they taught me in medical school, that life is a sexually transmitted disease with a 100% mortality rate. We have to recognize that dying is part of living and that everyone comes to that point. I find great personal satisfaction in accompanying patients through this part of their journey and in being there for them and for their families.
Interview by Kerry Elson
New Entrepreneurs profiles young businesses, 6-18 months old. Send your suggestions and contact information to kelson@mainebiz.biz.
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